Browsing by Author "Bogdanovic, Ivan (55376410100)"

Introduction Significant cranial defects result from a decompressive craniectomy following head trauma, malignant brain edema, intracranial hemorrhage, or resection of tumor affected bone. Unrepaired cranial defects are not just a tremendous esthetic problem. The underlying brain is unprotected, prone to injury, and this state can lead to the so-called “syndrome of the trephined” with mood instability, headaches, and even a neurological deficit. Currently, there is no widely accepted uniform technique of cranial vault shape restoration. Combining 3D technology with the use of polymethylmethacrylate is a challenging field that can bring good functional and aesthetic results and, in the case of smart design, become efficient, low-cost technology. We offer a possible solution to a problem that would be acceptable in neurosurgical practice. Case outline We present a 37-year-old male patient with a massive hemicranial defect as a consequence of previous decompressive craniectomy following severe craniocerebral injury the previous year. Together with engineers from the appropriate 3D modeling studio, we have designed a two-part mold by laser printing technology using biocompatible advanced polyamide. We made a customized polymethylmethacrylate graft intraoperatively using this mold and achieved good aesthetic results. Conclusion Reports of 3D printing assisted cranioplasties are growing, describing different techniques and cost-estimation. We hope to introduce a low-cost and simple method for repairing a skull defect. © 2022, Serbia Medical Society. All rights reserved.

Objective: Risk factors for epilepsy in meningioma patients are not yet clearly defined, however, seizure freedom is a significant factor for quality of life after surgery. Methods: We performed a retrospective study of the 333 adult patients who received surgery for supratentorial meningioma at our center. Various clinical, radiological, and surgical variables were included in the multivariate regression, and the outcomes measured were the occurrence of seizure(s) preoperatively, during the hospitalization, and during the follow-up period. Results: A total of 89 (26.7%) patients experienced preoperative seizures, of whom 62.9% were seizure free after the surgery. Of 244 patients without epilepsy before surgery, 11.9% had at least one seizure postoperatively. In total, 63 of our patients (18.9%) experienced seizures after the surgery, of whom 20 had refractory epilepsy. Multivariate analysis identified the following predictors of preoperative seizures: the absence of headache (OR: 0.23, CI: 2.55–8.50), the presence of significant peritumoral edema (OR: 4.35, CI: 2.57–7.35), and younger age (OR: 0.97 per year increase, CI: 0.95–0.99). Factors associated with early postoperative seizures were: younger age (OR: 0.96 per year increase, CI: 0.93–0.99) and the presence of preoperative seizures (OR: 2.73, CI: 1.13–6.57), while the presence of preoperative seizures (OR: 4.73, CI: 2.05–10.92), tumor progression (OR: 5.38, CI: 2.25–12.89), and neurological worsening (OR: 5.21 CI: 1.72–15.81) were significant for late postoperative seizures. Significance: Our results from a single-center meningioma cohort confirm, in general, data from some previous studies regarding patients' characteristics for both preoperative and overall postoperative epilepsy. Besides previously described risk factors, younger age was important for preoperative and early postoperative seizures. Epilepsy is common in patients with recurrence of meningioma, but the variables of significance for refractory seizures in these patients require further examination. © 2023 International League Against Epilepsy.

Objective: Risk factors for epilepsy in meningioma patients are not yet clearly defined, however, seizure freedom is a significant factor for quality of life after surgery. Methods: We performed a retrospective study of the 333 adult patients who received surgery for supratentorial meningioma at our center. Various clinical, radiological, and surgical variables were included in the multivariate regression, and the outcomes measured were the occurrence of seizure(s) preoperatively, during the hospitalization, and during the follow-up period. Results: A total of 89 (26.7%) patients experienced preoperative seizures, of whom 62.9% were seizure free after the surgery. Of 244 patients without epilepsy before surgery, 11.9% had at least one seizure postoperatively. In total, 63 of our patients (18.9%) experienced seizures after the surgery, of whom 20 had refractory epilepsy. Multivariate analysis identified the following predictors of preoperative seizures: the absence of headache (OR: 0.23, CI: 2.55–8.50), the presence of significant peritumoral edema (OR: 4.35, CI: 2.57–7.35), and younger age (OR: 0.97 per year increase, CI: 0.95–0.99). Factors associated with early postoperative seizures were: younger age (OR: 0.96 per year increase, CI: 0.93–0.99) and the presence of preoperative seizures (OR: 2.73, CI: 1.13–6.57), while the presence of preoperative seizures (OR: 4.73, CI: 2.05–10.92), tumor progression (OR: 5.38, CI: 2.25–12.89), and neurological worsening (OR: 5.21 CI: 1.72–15.81) were significant for late postoperative seizures. Significance: Our results from a single-center meningioma cohort confirm, in general, data from some previous studies regarding patients' characteristics for both preoperative and overall postoperative epilepsy. Besides previously described risk factors, younger age was important for preoperative and early postoperative seizures. Epilepsy is common in patients with recurrence of meningioma, but the variables of significance for refractory seizures in these patients require further examination. © 2023 International League Against Epilepsy.

Aneurysms of the temporal superficial artery (TSA) are very rare clinical entity. From 1861 to the present day, is described less than 200 cases. The most common cause of these aneurysms is so called blunt head trauma but there are described many cases of iatrogenic aneurysms, very rarely, aneurysms arise spontaneously. We report a case of 17-yearold patient with spontaneously formatting aneurysm of TSA. Three months prior to admission, he noticed the existence of tumefaction localized frontotemporal on the right side. MSCT angiography of blood vessels of the scalp showed an aneurysm on the frontal branch of TSA diameter of 15 mm. The aneurysm was resected with uneventful postoperative course. PH findings pointed to a true aneurysm. Treatment protocol for the aneurysms of the TSA include clinical monitoring, compression of the aneurysm, the injection of thrombin, endovascular treatment and surgical resection. Surgical resection has proven to be a safe and effective treatment modality and still is the method of choice. © 2019, University of Kragujevac, Faculty of Science. All rights reserved.